中国实用外科杂志

中国实用外科杂志

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甲状腺髓样癌预后相关因素分析（附118例报告）

高云飞，邓维叶，陈艳峰，欧阳电，杨中元，李秋梨，李    茵，王    曦，张    诠，杨安奎，郭朱明   

  1. 中山大学肿瘤防治中心华南肿瘤学国家重点实验室  肿瘤医学协同创新中心头颈科，广东广州 510060
  • 出版日期:2015-09-01 发布日期:2015-08-28

  • Online:2015-09-01 Published:2015-08-28

摘要：

目的    探讨影响甲状腺髓样癌（medullary thyroid carcinoma，MTC）预后的因素。方法　回顾性分析中山大学肿瘤防治中心2000年1月至2014年11月间收治的118例MTC的临床资料，并进行随访，采用单因素、多因素分析统计影响其预后的相关因素。结果　118例MTC病人无疾病存活率（disease free survival，DFS）为73%。1 年、3年、5年、10 年的总存活率（overall survival，OS）分别是97%、95%、94%、89%；单因素分析显示原发灶大小、顽固性腹泻、包膜外侵犯（extra thyroid extension，ETE）、上纵隔淋巴结转移、远处转移及复发影响预后；多因素分析显示顽固性腹泻、上纵隔淋巴结转移及远处转移是影响患者生存的独立预后因素。研究中虽然血清降钙素（ct）值在单、多因素分析均无统计学意义，但其动态变化有预测复发的趋势。结论　存在顽固性腹泻、上纵隔淋巴结转移及远处转移的MTC病人的预后差，需进行密切随访和相应处理。另外，术前行血清ct值测量和术后长期随访血清ct值动态变化对MTC预后的评估有一定的价值。

关键词: 甲状腺髓样癌, 预后, 随访

Abstract:

Prognostic factors of medullary thyroid carcinoma: An analysis of 118 patients        GAO Yun-fei，DENG Wei-ye，CHEN Yan-feng，et al. Department of Head and Neck Surgery，Sun Yat-sen University Cancer Center；State Key Laboratory of Oncology in South China；Collaborative Innovation Center of Cancer Medicine，Guangzhou 510060，China
Corresponding author: GUO Zhu-ming，E-mail：guozhm@sysucc.org.cn
Abstract    Objective    To investigate prognostic factors of medullary thyroid carcinoma (MTC)．Methods    The clinical data of 118 consecutive patients with MTC admitted from January 2000 to November 2014 in Sun Yat-sen University Cancer Center were analyzed retrospectively. Related prognostic factors were analyzed by univariate analysis and multivariate analysis．Results    The disease free survival (DFS) rate of 118 patients was 73%，and the overall survival (OS) rate of 1-year，3-year，5-year and 10-year was 97%, 95%, 94% and 89% respectively．In univariate analysis，tumor diameter，intractable diarrhea, extra thyroid extension（ETE），superior mediastinum lymph nodes (LN) metastasis，distant metastasis and recurrence were significant influencial factors of the prognosis．In multivariate analysis，intractable diarrhea，superior mediastinum LN metastasis and distant metastasis were independent prognostic factors．Although serum calcitonin (ct) level was not an independent prognostic factor，its dynamic change might predict the recurrence. Conclusion    Patients with MTC accompany with intractable diarrhea，superior mediastinum LN metastasis and distant metastasis usually get a poor prognosis，should be followed up closely. Serum ct value should be measured before and after surgery, which has a considerable value to evaluate the prognosis for patients with MTC.

Key words: medullary thyroid carcinoma, prognosis, follow up